Ischemia With No Obstruction of Coronary Arteries: Underlying Mechanisms and the Impact of Exercise Training (EXINOCA)

What this Trial Is About

This research investigates coronary microvascular dysfunction (CMD) in patients experiencing chest pain without narrowing of the heart's coronary arteries, a condition known as ischemia with no obstructive coronary artery disease (INOCA). The study explores whether this reduced microvascular function also affects other body organs and whether regular aerobic exercise can improve this heart condition and symptoms. The trial aims to better understand CMD mechanisms and assess exercise training effects in these patients. Participants will be randomly assigned to one of two groups: an exercise training group or a control group. The exercise group will engage in supervised cycling sessions lasting 40-50 minutes, three times weekly for 12 weeks. These sessions include warm-up, interval cycling at varying intensities, and cool-down phases, with progressive intensity throughout the program. Home training up to once weekly is allowed if intensity levels are maintained. The control group will not receive training during the study but will be offered exercise afterward. Participants are encouraged to maintain their usual lifestyle and medications. During the study, researchers will monitor changes in coronary microvascular function using myocardial blood flow reserve measurements before and after three months. They will also assess symptoms using angina questionnaires, exercise capacity, and blood flow in skin, muscle, and fat tissue. Training sessions are closely supervised with heart rate and exertion monitoring to ensure safety and effectiveness. The total participation duration includes the 12-week intervention period with assessments at baseline and after three months.

Impact of Exercise Training on Ischemia With Non-Obstructive Coronary Arteries (INOCA): The ExINOCA Study